BHA4110 Health Care Operations and systems.


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What is a Health care system?

A health care system refers to the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations.

4 types of health care systems.

There are 4 major health care models. These are namely:

  1. The Beveridge model.
  2. The Bismarck model.
  3. National health insurance model.
  4. The private insurance model.

Goals of Health care systems.

The following are the goals of health care systems:

  • Health care systems aim to improve the quality of the care provided.
  • Health care systems aim to improve patient outcomes.
  • They aim to reduce the cost of care.

Functions of Healthcare systems.

The following are the 4 basic functions that are performed by a health care system:

  1. Provision of a better quality of healthcare.
  2. Stewardship
  3. Financing and,
  4. Developing resources in the healthcare sector such as human, physical, and knowledge.

What is health care operations management?

Operations management is the process of designing a firm so that its resources are used efficiently, with the ultimate objective of creating efficiency, especially the maximum feasible degree of efficiency. The solutions and strategies for operations management are centered on assessing and improving corporate processes and procedures. Because the process begins with an analysis of the internal processes and barriers that exist inside a given organization, operations management may be used in any sector.

In the healthcare sector, operations management refers to the oversight of a healthcare facility’s day-to-day procedures that affect the client experience and organizational goals. Procedures involved in operations management in healthcare can be broken down into 3 categories namely:

  1. Administrative
  2. Financial and,
  3. Legal

functions of health care systems


Administrative practices involve performing tasks such as keeping detailed records of medical and office supplies, supplying employees and updating patient records.


Some of the financial duties in health care operations management include managing claims, medical billing, revenue cycle management and value-based reimbursement.


Legal responsibilities in healthcare operations mainly revolve around compliance and credentialing.

Benefits of Successful Healthcare Operations.

There are several benefits of successful health care operations. Some of these benefits include:

  • Better client experience.
  • Improved employee productivity.
  • Improved bottom line and competitive edge.


Better client experience.

Clients are more aware than ever before, and they have great expectations for healthcare services than ever before. Thus, providing excellent customer service is critical in any organization, but it is especially critical in healthcare, where every encounter can have serious implications. Giving staff the skills they need to be confident and effective in client encounters ensures that they are well-prepared to provide high-quality service.

To make it easy to build long-term partnerships that will allow you to service more clients and grow your business, you have to be able to give a consistent, high-quality experience to your clients. Healthcare facilities can achieve this by simply:

  • Providing healthcare staff with simple solutions for communication.
  • Data monitoring, and
  • Providing appointment scheduling service.

Improved employee productivity.

Successful health care facilities often have a strong healthcare operation that is backed up by centralized technology. This helps to keep the focus where it belongs, that is on patients. Thus, strong health care operations help to reduce and remove operational bottlenecks allowing doctors, nurses, home health aides, lab technicians, and other staff workers to be more productive.

Improved bottom line and competitive edge.

Building and maintaining a profitable healthcare firm necessitates ensuring that operations function as efficiently as possible while keeping staff and customers delighted. Additionally, providing more efficient processes results in less wasted time and money which directly translates to higher profit margins.

Health care operations can improve in the following areas:

  • Automating or simplifying important tasks.
  • Clarifying roles.
  • Identifying patient trends.

Ways of Improving Operations Management in Healthcare.

The following are different methods through which healthcare facilities can improve their operations management:

  • Collecting and leveraging the right data.
  • Automating healthcare processes wherever possible.
  • Enhancing communication in the health care facility.
  • Providing better tools for their workers.
  • Ensuring that the entire healthcare facility is connected. i.e integrating with the existing processes in the healthcare facility such as payroll, hr, and claims.
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